| NPI | 1104908011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MI 4301053726) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301053726) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2019-12-12 |